Stroke Flashcards
Define Stroke
Acute onset of focal neurological symptoms and signs due to disruption of blood supply
What are the two types of stroke and which one is most common?
Haemorrhagic (15-20%)
Ischemic (80-85%)
What is a haemorrhagic stroke?
bleeding occurs inside or around the brian tissue
What is an ischaemic stroke?
a clot blocks blood flow to an area of the brain
What are the causes of hemorrhagic strokes?
Raised blood pressure
Weakened blood vessel wall due to
- structural abnormalities like aneurysm,
arteriovenous malformation (AVM)
- inflammation of vessel wall (vasculitis)
What are the causes of ischaemic strokes?
Thrombotic- clot blocking artery at the site of occlusion
Embolic- clot blocking artery has travelled to artery it occludes from somewhere more proximal in the arteries or the heart
Hypoperfusion- due to reduced flow of blood due to stenosed artery rather than occlusion of artery (artery isn’t blocked it is just narrowed)
What are the modifiable risk factors for strokes?
Hypertension Hyperlipidaemia Smoking Prior history of TIA Atrial fibrillation Diabetes Congestive heart failure Alcohol excess Obesity Physical inactivity Poor socioeconomic status
What are the non modifiable risk factors for strokes?
Age Family history of stroke/any CVD Gender Race Previous stroke Born with a clotting deficiency
What is the inital management (0-4hrs) of ischaemic strokes?
Thrombolysis or Thrombectomy
What investigation would you do to determine the type of stroke?
Brain scan
What imaging investigations would you do to determine strokes?
CT Brain +/- angiography
MRI with DWI +/- angiography (ischemia)
MRI with SWI - looks for old haemosiderin deposits(old bleed)
Strokes are focal - what does this mean?
from the patients symptoms you can tell where the trouble is in the brain
What are the two types of ischaemic embolic strokes?
Atheroembolic (from a thrombus formed on atherosclerosisclerotic plaques)
Cardioembolic (from a clot formed in the heart)
What is the management of strokes?
If Atheroembolic or due to thrombus = Antiplatelets Statins to treat high lipids Diabetes management Hypertension management Lifestyle advice If due to AF - anticoagulate (warfarin)
What is warfarin an antagonist of?
Vitamin K
